Dexamethasone: Coronavirus breakthrough as £5 steroid dexamethasone could have saved lives of 5,000 who died in UK claims Professor Martin Landray
A steroid called dexamethasone could have saved the lives up to 5,000 people had it been used to treat people battling COVID-19 in hospitals throughout the United Kingdom, claims Professor Martin Landray.
Professor Landray is the lead researcher on a study looking at the effects of dexamethasone on COVID-19 patients on ventilators and patients using oxygen.
The RECOVERY trial (which stands for ‘Randomised Evaluation of COVid-19 thERapY’) was funded by UKRI as part of the UKRI/DHSC/NIHR COVID-19 rapid research response.
The drug, which is currently used to treat ulcerative colitis, arthritis and some types of cancer, was found to have reduced the number of deaths of patients on ventilators and patients requiring oxygen by a third and by a fifth respectively.
Professor Peter Horby and Professor Martin Landray, chief investigators of the trial, said in a statement: "In March of this year, RECOVERY was established as a randomised clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone (a steroid treatment). Over 11,500 patients have been enrolled from over 175 NHS hospitals in the UK.
"On June 8, recruitment to the dexamethasone arm was halted since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.
"A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).
"Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14).
"Based on these results, one death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.
"Given the public health importance of these results, we are now working to publish the full details as soon as possible.
"Overall dexamethasone reduced the 28-day mortality rate by 17% (0.83 [0.74 to 0.92]; P=0.0007) with a highly significant trend showing greatest benefit among those patients requiring ventilation (test for trend p<0.001). But it is important to recognise that we found no evidence of benefit for patients who did not require oxygen and we did not study patients outside the hospital setting. Follow-up is complete for over 94% of participants."